- Sutter Health (Sacramento, CA)
- …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the ... to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission… more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of … more
- Alameda Health System (Oakland, CA)
- …placement (eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may ... System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening +… more
- LA Care Health Plan (Los Angeles, CA)
- …and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and ... Utilization Management Nurse Specialist RN II Job Category:...cases and reports are maintained and referred to the Physician Advisor /UM Director. Document in platform/system of… more
- Alameda Health System (Oakland, CA)
- …placement (eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may ... knowledge of current trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care) by participating in… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …required; Experience supervising physicians and supporting utilization management as a Physician Utilization Management Advisor (PUMA) is preferred; Must ... L. Pettis Memorial Veterans Hospital is recruiting for a Full-Time, Permanent, Physician , Chief of Inpatient Medicine and reports directly to the ED-Inpatient… more
- Sharp HealthCare (San Diego, CA)
- …pre-admission review , utilization management, and concurrent and retrospective review Process. Performs and mentor's physician training of A&G and UM ... selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations for updating current polices to meet… more
- Sharp HealthCare (San Diego, CA)
- …selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations. + Participates in the retrospective ... the membership. Serves as a medical manager and policy advisor to SHP and its Chief Medical Officer. Is...to accrediting and regulatory agency feedback. + Supports pre-admission review , utilization management, and concurrent and retrospective… more
- Sharp HealthCare (La Mesa, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... Care Management and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM will:Conduct initial… more
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